Person Information

Name:JOANN GALLAGHER DITALIA

Address Information

Address(city state zipcode):collingswood NJ08108

License Information

Type:Certified Registered Nurse PractitionerSecondary Type:Pediatric Acute ChronicNumber:VP004146N
Profession:NursingStatus:InactiveDate This Status:11/1/2013
Issue Date:11/13/1996Expires:10/31/2013Last Renewed:8/20/2011

Prerequisite Information

Licensee:DITALIA, JOANN GALLAGHERRelationship:Prescriptive Authority
Type:Prescriptive AuthorityNumber:002559Status:Inactive
Date of Association:Date of Expiration:

Licensee:DITALIA, JOANN GALLAGHERRelationship:Self Automatic
Type:Registered NurseNumber:RN164190LStatus:Inactive
Date of Association:Date of Expiration:

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